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General NPI Number Information
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NPI Number | 1578627238
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Entity Type | Individual
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Provider Name | BRUCE STEWART HARRIS DDS
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Gender | Male
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Dates
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Enumeration Date | 12/20/2006
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Last Update Date | 11/06/2018
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Provider Practice Location Address
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Address Line | 2563 EVENING SKY DRIVE
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City | HENDERSON
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State | NV
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Zip | 89052
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Country | US
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Telephone | 949-275-1631
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Fax | 714-964-4999
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Provider Business Mailing Address
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Address Line | 2563 EVENING SKY DRIVE
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City | HENDERSON
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State | NV
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Zip | 89052
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Country | US
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Telephone | 949-275-1631
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Fax | 714-964-4999
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | DJ19622
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | 19622
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 1223X0400X
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Taxonomy Name | Orthodontics and Dentofacial Orthopedics Dentistry
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License Number | S3-315C
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License Number State | NV
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